Tanya Kormeili, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A83828 Issued in CA

Practice address

2811 Wilshire Blvd Ste 640
Santa Monica, CA 90403-4823

Phone

(310) 526-8301

NPI assigned

Apr 26, 2007

Last updated

Aug 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of California, Geffen School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanya Kormeili MD PCGroup PAC ID 3274607692, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00293

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tanya Kormeili, MD, PC

  dba Derm & Rejuvenation Institute

  • Dermatology Physician
  • Santa Monica, CA
  • NPI 1477758159
  Medicare reassignment Care Compare group NPD Authorized official
• James H.Sternberg, M.D. a Medical Corporation

  • Procedural Dermatology Physician
  • Los Angeles, CA
  • NPI 1942317342
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1245450766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD STE 640",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034823",
            "telephone_number": "310-526-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD STE 640",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034823",
            "telephone_number": "310-526-8301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 15th St",
            "address_2": "Suite 709",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041135",
            "country_code": "US",
            "telephone_number": "310-917-4433",
            "fax_number": "310-917-4432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1260 15th St",
            "address_2": "Suite 709",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041135",
            "country_code": "US",
            "telephone_number": "310-917-4433",
            "fax_number": "310-917-4432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORMEILI",
        "first_name": "TANYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A83828",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A83838",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A83828",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "CA",
            "license": "A83828",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "A83828",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A83828",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "WA83828A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott S Kopoian, PH.D.
• Miriam Kopstein
• Djamal Kord, L.AC.
• Lauren Kordonsky, PT, DPT
• Alissa Koritsoglou
• Nurit Korn, MD
• Aleksey Korolyov
• Akhil Korrapati, DPM
• Jadwiga Korzec, DDS
• David Koshki, DDS

• Dermatology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.